NPI | 1073148003 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101274233) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101274233) |
Enumeration Date | 2020-03-10 |
Last Update Date | 2023-08-14 |