NPI | 1780850743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME158452) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2012023203) |
Enumeration Date | 2008-04-30 |
Last Update Date | 2022-08-22 |