NPI | 1740693696 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 83708) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151010877) |
207R00000X Internal Medicine (Licence: MI L283875) | |
Enumeration Date | 2014-06-09 |
Last Update Date | 2020-07-21 |