NPI | 1881181618 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO TL.0007275) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 12335288-1204) |
Enumeration Date | 2018-04-17 |
Last Update Date | 2021-06-17 |