NPI | 1619468733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS021474) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT018253) |
Enumeration Date | 2018-05-24 |
Last Update Date | 2021-12-14 |