NPI | 1841482445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD203580) |
Additional Taxonomies | 261Q00000X (Licence: LA MD203580) |
Enumeration Date | 2007-08-16 |
Last Update Date | 2023-03-07 |