NPI | 1760045462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5151013421) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 4704) |
Enumeration Date | 2019-04-17 |
Last Update Date | 2022-09-13 |