NPI | 1487961918 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD449621) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197710) |
Enumeration Date | 2010-09-03 |
Last Update Date | 2025-09-29 |