NPI | 1669443065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 058080) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 0s8462) |
Enumeration Date | 2006-02-01 |
Last Update Date | 2019-03-03 |