NPI | 1760777627 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 33366) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A116924) |
Enumeration Date | 2011-06-17 |
Last Update Date | 2022-03-30 |