NPI | 1598152449 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A163855) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 17786) |
Enumeration Date | 2015-04-17 |
Last Update Date | 2020-10-15 |