NPI | 1578593216 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD033949E) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX K4247) |
Enumeration Date | 2006-07-04 |
Last Update Date | 2022-06-22 |