NPI | 1336706621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD18294) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP04580) |
Enumeration Date | 2019-05-22 |
Last Update Date | 2022-11-30 |