NPI | 1669621215 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 063080) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME120196) |
Enumeration Date | 2008-09-18 |
Last Update Date | 2022-06-14 |