NPI | 1922283266 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME108006) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2005-01841) |
Enumeration Date | 2008-01-07 |
Last Update Date | 2023-12-13 |