NPI | 1710237847 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 174586) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 15963) |
Enumeration Date | 2012-09-17 |
Last Update Date | 2022-03-10 |