NPI | 1457400160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101058819) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD30344) |
207R00000X Internal Medicine (Licence: MD D0071847) | |
Enumeration Date | 2007-01-10 |
Last Update Date | 2022-02-08 |