NPI | 1457701831 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD474758) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT210708) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2021-08-11 |