NPI | 1427637123 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61568300) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD221513) |
207R00000X Internal Medicine (Licence: CA A196506) | |
Enumeration Date | 2021-04-07 |
Last Update Date | 2024-08-20 |