NPI | 1235781980 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036173614) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351044115) |
Enumeration Date | 2019-07-12 |
Last Update Date | 2025-05-19 |