NPI | 1508175530 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS12102) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO2460) |
Enumeration Date | 2010-09-24 |
Last Update Date | 2022-05-25 |