NPI | 1124607379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A183778) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL6700) |
Enumeration Date | 2021-04-05 |
Last Update Date | 2024-07-01 |