NPI | 1235794520 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO3013) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1423) |
208D00000X General Practice (Licence: NV DO3013) | |
Enumeration Date | 2019-05-02 |
Last Update Date | 2022-10-17 |