NPI | 1962644120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 157128) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 34353) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2019-02-19 |