NPI | 1700447117 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 33344) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 67810) |
Enumeration Date | 2019-06-26 |
Last Update Date | 2024-10-18 |