NPI | 1710143326 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G178866) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 15309) |
Enumeration Date | 2008-08-03 |
Last Update Date | 2023-03-06 |