NPI | 1710447628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A186395) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MDR-7700) |
207R00000X Internal Medicine (Licence: HI MD-22539) | |
Enumeration Date | 2019-03-25 |
Last Update Date | 2023-07-01 |