NPI | 1104230002 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 69106) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60715834) |
Enumeration Date | 2014-06-18 |
Last Update Date | 2024-08-19 |