NPI | 1770094153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2846) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101023688) |
Enumeration Date | 2017-10-12 |
Last Update Date | 2023-08-17 |