NPI | 1740642081 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X (Licence: FL ME176785) |
Additional Taxonomies | 2085R0001X |
2085R0001X (Licence: TX T1486) | |
207R00000X Internal Medicine | |
Enumeration Date | 2016-03-25 |
Last Update Date | 2025-09-19 |