NPI | 1174936330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A149567) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105533) |
Enumeration Date | 2014-06-05 |
Last Update Date | 2022-07-21 |