NPI | 1730234030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 82722) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239038) |
207R00000X Internal Medicine (Licence: DC MD034363) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2019-10-29 |