NPI | 1235659822 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 89132) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD471261) |
Enumeration Date | 2017-06-23 |
Last Update Date | 2023-06-27 |