NPI | 1639608946 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2025010418) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301501839) |
Enumeration Date | 2017-06-08 |
Last Update Date | 2025-07-03 |