NPI | 1508251596 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301511906) |
Additional Taxonomies | 208D00000X General Practice (Licence: WI 68102-20) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2024-07-03 |