NPI | 1316908593 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD421579) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101234850) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2023-11-29 |