NPI | 1407900400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101050599) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 155019) |
Enumeration Date | 2007-01-23 |
Last Update Date | 2022-04-29 |