NPI | 1609031442 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME110960) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 237836) |
Enumeration Date | 2008-07-22 |
Last Update Date | 2022-05-05 |