NPI | 1578946117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01086014A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107352) |
Enumeration Date | 2015-07-01 |
Last Update Date | 2021-06-24 |