NPI | 1720243181 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P5983) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD443160) |
207R00000X Internal Medicine (Licence: OH 35.120688) | |
207R00000X Internal Medicine (Licence: PA MT193132) | |
Enumeration Date | 2008-07-25 |
Last Update Date | 2024-03-14 |