NPI | 1710482690 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A164886) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA A164886) |
Enumeration Date | 2018-03-24 |
Last Update Date | 2023-09-12 |