NPI | 1134357049 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME159515) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 82198) |
207R00000X Internal Medicine (Licence: NC 2010-01715) | |
Enumeration Date | 2009-06-30 |
Last Update Date | 2024-08-08 |