NPI | 1649219833 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A99250) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 23216) |
207R00000X Internal Medicine (Licence: SC 26725) | |
Enumeration Date | 2006-06-05 |
Last Update Date | 2022-01-04 |