NPI | 1720096928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 29784020) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 29784-020) |
Enumeration Date | 2006-08-03 |
Last Update Date | 2025-04-30 |