NPI | 1215321971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 79930) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 208316) |
Enumeration Date | 2015-03-20 |
Last Update Date | 2024-08-15 |