NPI | 1386910107 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65511) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC DO034502) |
Enumeration Date | 2012-03-26 |
Last Update Date | 2020-08-19 |