NPI | 1104976141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A111144) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD12719) |
207R00000X Internal Medicine (Licence: MA 230797) | |
Enumeration Date | 2007-01-11 |
Last Update Date | 2023-03-07 |