NPI | 1891178521 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 1891178521) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 42776) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2021-07-19 |