NPI | 1356086250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR PG211595) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A23979) |
Enumeration Date | 2022-05-04 |
Last Update Date | 2025-08-29 |