NPI | 1144264268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 92842) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 92842) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2024-06-05 |