NPI | 1467890335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD459538) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT205120) |
Enumeration Date | 2013-06-12 |
Last Update Date | 2022-09-20 |