NPI | 1770335374 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 80367) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 34240) |
Enumeration Date | 2024-04-05 |
Last Update Date | 2025-07-31 |