NPI | 1174327134 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL94616) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL94616) |
Enumeration Date | 2025-04-01 |
Last Update Date | 2025-07-17 |