NPI | 1174505507 |
---|---|
Professional Name | NONE NONE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 231400) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 3466) |
Enumeration Date | 2005-11-21 |
Last Update Date | 2023-08-09 |