NPI | 1588003479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 95600) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3654) |
207R00000X Internal Medicine (Licence: TN 3042) | |
207R00000X Internal Medicine (Licence: FL OS 12936) | |
Enumeration Date | 2013-06-24 |
Last Update Date | 2024-06-04 |