NPI | 1114236932 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME117689) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301097585) |
Enumeration Date | 2010-09-28 |
Last Update Date | 2024-09-03 |