NPI | 1265069710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME174956) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.076413) |
Enumeration Date | 2020-03-25 |
Last Update Date | 2025-09-26 |