NPI | 1326288697 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO163005) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS 10859) |
207Q00000X Family Medicine (Licence: MI 5101017928) | |
Enumeration Date | 2009-02-26 |
Last Update Date | 2025-09-09 |