NPI | 1942204383 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 39961) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 33982) |
207R00000X Internal Medicine (Licence: MN 107529) | |
Enumeration Date | 2005-06-13 |
Last Update Date | 2020-08-13 |