NPI | 1043964794 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0116036502) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0116036502) |
Enumeration Date | 2022-02-10 |
Last Update Date | 2024-06-09 |