NPI | 1407598311 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V6983) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 747262) |
Enumeration Date | 2022-04-11 |
Last Update Date | 2025-08-15 |