NPI | 1720066350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME77816) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 104045) |
Enumeration Date | 2006-01-04 |
Last Update Date | 2023-05-30 |