NPI | 1689104358 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301504892) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 14519A) |
208600000X Surgery (Licence: MI 4301504892) | |
Enumeration Date | 2017-06-15 |
Last Update Date | 2023-12-29 |