NPI | 1356759286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 18256) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV ED0444A) |
Enumeration Date | 2014-07-23 |
Last Update Date | 2024-07-30 |