NPI | 1770160178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2025-0732) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 73507) |
Enumeration Date | 2021-03-24 |
Last Update Date | 2025-07-11 |