NPI | 1922501204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC MDO.83463) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101025371) |
Enumeration Date | 2018-03-13 |
Last Update Date | 2021-06-28 |