NPI | 1730504879 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME172811) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101260378) |
Enumeration Date | 2014-02-26 |
Last Update Date | 2025-06-17 |