NPI | 1588250609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 80339) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 34236) |
Enumeration Date | 2020-12-13 |
Last Update Date | 2025-07-30 |