NPI | 1982922498 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 86071) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019013765) |
207R00000X Internal Medicine (Licence: NC 201401212) | |
Enumeration Date | 2010-05-07 |
Last Update Date | 2024-01-25 |