NPI | 1194827972 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME124498) |
Additional Taxonomies | 208D00000X General Practice (Licence: PR 16534) |
Enumeration Date | 2006-09-02 |
Last Update Date | 2023-10-20 |