NPI | 1275106536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 71927) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 31722) |
Enumeration Date | 2021-07-22 |
Last Update Date | 2022-08-17 |