NPI | 1689265621 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 84979-20) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01086321A) |
207R00000X Internal Medicine (Licence: PA MD472568) | |
Enumeration Date | 2021-02-02 |
Last Update Date | 2025-08-22 |