NPI | 1861481574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-21457) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 10541) |
207R00000X Internal Medicine (Licence: UT 6069563-1205) | |
Enumeration Date | 2005-10-14 |
Last Update Date | 2021-06-09 |