NPI | 1184621138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD10232) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI md1032) |
Enumeration Date | 2005-07-06 |
Last Update Date | 2021-06-25 |