NPI | 1295182731 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 55956) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME139375) |
Enumeration Date | 2016-05-14 |
Last Update Date | 2023-08-09 |