NPI | 1689746166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101055858) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0072076) |
207R00000X Internal Medicine (Licence: DC MD039289) | |
Enumeration Date | 2006-11-14 |
Last Update Date | 2021-05-27 |