NPI | 1578994984 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 65455) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 273470) |
207R00000X Internal Medicine (Licence: IA 41576) | |
Enumeration Date | 2013-12-11 |
Last Update Date | 2024-05-17 |