NPI | 1649624347 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0068173) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10055352) |
Enumeration Date | 2016-04-19 |
Last Update Date | 2022-05-09 |