NPI | 1457375040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R9445) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G88832) |
Enumeration Date | 2006-07-27 |
Last Update Date | 2022-09-20 |