NPI | 1154982130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A179035) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT218082) |
Enumeration Date | 2019-06-21 |
Last Update Date | 2022-09-19 |