NPI | 1689633927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX J3974) |
Additional Taxonomies | 208D00000X General Practice (Licence: TX J3974) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2025-05-06 |