NPI | 1629053277 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 052184) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 39951) |
Enumeration Date | 2005-12-07 |
Last Update Date | 2019-11-01 |