NPI | 1700265014 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 1700265014) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301107603) |
Enumeration Date | 2015-05-20 |
Last Update Date | 2018-12-11 |