NPI | 1205586641 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74764) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 1023995) |
207R00000X Internal Medicine (Licence: MN 32559) | |
Enumeration Date | 2022-03-28 |
Last Update Date | 2025-06-17 |