NPI | 1043802929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2022041862) |
Additional Taxonomies | 208D00000X General Practice (Licence: MO 2022041862) |
Enumeration Date | 2021-02-11 |
Last Update Date | 2024-07-08 |