NPI | 1932104015 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 11759) |
Additional Taxonomies | 174400000X Specialist (Licence: PR 11759) |
Enumeration Date | 2005-06-16 |
Last Update Date | 2020-04-13 |