NPI | 1245727791 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0094904) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101272653) |
Enumeration Date | 2018-04-20 |
Last Update Date | 2022-07-07 |