NPI | 1487130936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74647) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 32609) |
Enumeration Date | 2018-07-18 |
Last Update Date | 2023-07-12 |