NPI | 1457516254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME128847) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD13698) |
Enumeration Date | 2008-07-22 |
Last Update Date | 2020-01-14 |