NPI | 1396971370 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME150972) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD445187) |
Enumeration Date | 2009-06-04 |
Last Update Date | 2024-10-04 |