NPI | 1447291109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-9514) |
Additional Taxonomies | 174400000X Specialist (Licence: MT 9514) |
Enumeration Date | 2006-06-10 |
Last Update Date | 2021-05-10 |