NPI | 1083243703 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 78802) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U4878) |
Enumeration Date | 2020-04-04 |
Last Update Date | 2025-01-14 |