NPI | 1881700284 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME131071) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 231634) |
207R00000X Internal Medicine (Licence: RI LP00154) | |
Enumeration Date | 2006-08-21 |
Last Update Date | 2021-11-19 |