NPI | 1740666833 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME159524) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD464308) |
Enumeration Date | 2015-07-31 |
Last Update Date | 2023-07-18 |