NPI | 1629277454 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 243137) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 046709) |
207R00000X Internal Medicine (Licence: RI MD16969) | |
Enumeration Date | 2007-07-12 |
Last Update Date | 2023-08-08 |