NPI | 1780208793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A187092) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05043) |
Enumeration Date | 2020-06-04 |
Last Update Date | 2023-06-19 |