NPI | 1356909311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-15657) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 250254) |
Enumeration Date | 2019-06-04 |
Last Update Date | 2025-05-19 |