NPI | 1508015512 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 46563) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 64348) |
207R00000X Internal Medicine (Licence: KY 52988) | |
Enumeration Date | 2008-09-15 |
Last Update Date | 2020-01-08 |