NPI | 1518306570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2022-1256) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125063902) |
207R00000X Internal Medicine (Licence: WA MD61203457) | |
207R00000X Internal Medicine (Licence: KS 04-40350) | |
Enumeration Date | 2013-06-22 |
Last Update Date | 2024-03-13 |