NPI | 1700379351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R76670) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-21800-0) |
Enumeration Date | 2018-06-08 |
Last Update Date | 2021-04-30 |