NPI | 1649210683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD040086E) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA md-1696803) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2021-03-02 |