NPI | 1063580413 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 25933) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI YL058737) |
Enumeration Date | 2006-12-02 |
Last Update Date | 2025-06-04 |