NPI | 1386066173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 107868) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01091148A) |
Enumeration Date | 2014-01-13 |
Last Update Date | 2023-07-27 |