NPI | 1407293103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 58967) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ R74099) |
Enumeration Date | 2013-06-04 |
Last Update Date | 2020-03-04 |