NPI | 1992159305 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX U9838) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 58612) |
207R00000X Internal Medicine (Licence: FL ME160801) | |
Enumeration Date | 2016-04-21 |
Last Update Date | 2024-07-17 |