NPI | 1225325764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301099418) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM FELMD2020-053) |
Enumeration Date | 2011-07-05 |
Last Update Date | 2021-02-11 |