NPI | 1669679007 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME170988) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC TL30226) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2025-02-21 |