NPI | 1356504856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 51005) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY TP181) |
207R00000X Internal Medicine (Licence: TN 510005) | |
Enumeration Date | 2008-07-03 |
Last Update Date | 2025-03-14 |