NPI | 1538798657 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X (Licence: FL ME175918) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME175918) |
Enumeration Date | 2020-04-02 |
Last Update Date | 2025-08-02 |