NPI | 1972661312 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102202065) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH RT 4889) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2021-08-17 |