NPI | 1255693305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 262882) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 251665) |
Enumeration Date | 2012-06-14 |
Last Update Date | 2019-11-24 |