NPI | 1336569904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 02005562A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 3196) |
Enumeration Date | 2014-04-22 |
Last Update Date | 2022-10-15 |