NPI | 1467974055 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01084309A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017014206) |
Enumeration Date | 2017-07-14 |
Last Update Date | 2022-07-21 |