NPI | 1649777897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX V3550) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A163679) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2025-06-02 |