NPI | 1306837257 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME128206) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 12081) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2020-03-04 |