NPI | 1972617744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 041448) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C160487) |
207R00000X Internal Medicine (Licence: IL 036.151442) | |
207R00000X Internal Medicine (Licence: ME MD23630) | |
207R00000X Internal Medicine (Licence: AL MD.43824) | |
207R00000X Internal Medicine (Licence: MS 15597) | |
Enumeration Date | 2006-08-18 |
Last Update Date | 2024-05-08 |