NPI | 1629481080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 54374) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ r74568) |
Enumeration Date | 2014-06-03 |
Last Update Date | 2019-02-19 |