NPI | 1720651227 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 33988) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OK 38218) |
Enumeration Date | 2021-07-21 |
Last Update Date | 2025-06-12 |