NPI | 1720433220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036154477) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 2616-320) |
207R00000X Internal Medicine (Licence: NV 18907) | |
Enumeration Date | 2016-05-03 |
Last Update Date | 2025-09-17 |