NPI | 1205862612 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301064977) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA c172881) |
Enumeration Date | 2006-06-25 |
Last Update Date | 2025-08-28 |