NPI | 1780265843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-18341) |
Additional Taxonomies | 261QS1000X Clinic/Center, Student Health |
Enumeration Date | 2021-04-19 |
Last Update Date | 2024-07-31 |