NPI | 1700292208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 390200000) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND PT14741) |
Enumeration Date | 2014-07-03 |
Last Update Date | 2022-07-21 |