NPI | 1902191687 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 257318) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA L-247524) |
Enumeration Date | 2011-06-10 |
Last Update Date | 2018-05-31 |