NPI | 1659500791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD20170090) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 52441) |
Enumeration Date | 2009-07-10 |
Last Update Date | 2024-10-14 |