NPI | 1720309545 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 35106) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD185542) |
207R00000X Internal Medicine (Licence: VT 042.0012722) | |
Enumeration Date | 2010-06-16 |
Last Update Date | 2025-06-09 |