NPI | 1669435772 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME126725) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD067664L) |
Enumeration Date | 2006-04-10 |
Last Update Date | 2016-06-23 |