NPI | 1891291878 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD482088) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 85931) |
Enumeration Date | 2018-03-30 |
Last Update Date | 2023-11-07 |