NPI | 1891813416 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G065257) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G652570) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2024-03-01 |