NPI | 1134212830 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 230684) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME83087) |
Enumeration Date | 2006-10-02 |
Last Update Date | 2023-01-11 |