NPI | 1750795167 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL me142485) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01081062A) |
207RG0300X Internal Medicine, Geriatric Medicine (Licence: MI 4301104704) | |
Enumeration Date | 2014-06-12 |
Last Update Date | 2021-04-20 |