NPI | 1710361506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 34667) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U5460) |
Enumeration Date | 2015-07-12 |
Last Update Date | 2024-03-20 |