NPI | 1760069256 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 33085) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 94512) |
Enumeration Date | 2021-03-29 |
Last Update Date | 2025-06-30 |