NPI | 1740401710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245166) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 0430668) |
207R00000X Internal Medicine (Licence: AK 5329) | |
Enumeration Date | 2007-05-01 |
Last Update Date | 2021-06-22 |