NPI | 1245724764 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X (Licence: OR MD223368) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071902) |
2085R0001X (Licence: DC MD210012205) | |
Enumeration Date | 2018-06-18 |
Last Update Date | 2025-06-27 |