NPI | 1902961907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD13265) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00034537) |
Enumeration Date | 2006-12-27 |
Last Update Date | 2024-03-25 |