NPI | 1558742510 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D85751) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT209526) |
Enumeration Date | 2015-06-16 |
Last Update Date | 2018-12-29 |