NPI | 1548640436 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 63942) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-10247) |
Enumeration Date | 2015-06-04 |
Last Update Date | 2022-01-31 |