NPI | 1548408867 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA DO-05360) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2007018754) |
Enumeration Date | 2009-01-23 |
Last Update Date | 2022-08-15 |