NPI | 1639437981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A13308) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 252638) |
Enumeration Date | 2012-04-24 |
Last Update Date | 2024-11-05 |