NPI | 1497910186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 66113) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD20110485) |
207R00000X Internal Medicine (Licence: PA MT193304) | |
207R00000X Internal Medicine (Licence: MN 62991) | |
Enumeration Date | 2008-07-23 |
Last Update Date | 2022-10-04 |