NPI | 1689667628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R2D36) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 04-26894) |
Enumeration Date | 2005-08-24 |
Last Update Date | 2020-11-25 |