NPI | 1770581225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD.11987R) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA L11987r) |
Enumeration Date | 2005-07-08 |
Last Update Date | 2021-08-10 |