NPI | 1184252355 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-48113) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.46376) |
207R00000X Internal Medicine (Licence: OR MD218127) | |
Enumeration Date | 2020-04-01 |
Last Update Date | 2023-12-14 |