NPI | 1639602139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 24089) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A156998) |
Enumeration Date | 2017-04-11 |
Last Update Date | 2025-05-12 |