NPI | 1124757315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL88052) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 88052) |
Enumeration Date | 2022-06-06 |
Last Update Date | 2025-05-16 |