NPI | 1033630785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2017019518) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2017019518) |
Enumeration Date | 2017-07-03 |
Last Update Date | 2023-12-24 |