NPI | 1538439559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME111310) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL ME 111310) |
Enumeration Date | 2012-01-06 |
Last Update Date | 2025-01-27 |