NPI | 1801887781 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101044535) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0037566) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2019-10-03 |