NPI | 1285384420 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74703) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32566) |
Enumeration Date | 2022-03-28 |
Last Update Date | 2023-07-14 |