NPI | 1467101360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 74322) |
Additional Taxonomies | 208D00000X General Practice (Licence: AZ 74322) |
Enumeration Date | 2022-03-20 |
Last Update Date | 2024-08-16 |