NPI | 1023571122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 89576) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 66092) |
207R00000X Internal Medicine (Licence: AZ R77234) | |
Enumeration Date | 2019-04-08 |
Last Update Date | 2023-06-25 |