NPI | 1063049732 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A22769) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102207620) |
Enumeration Date | 2020-03-24 |
Last Update Date | 2025-09-30 |