NPI | 1598051328 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0077432) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME157528) |
Enumeration Date | 2011-06-20 |
Last Update Date | 2022-09-28 |