NPI | 1114443918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 64275) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7984) |
Enumeration Date | 2017-08-14 |
Last Update Date | 2021-09-14 |