NPI | 1780313692 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME172097) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL 35152) |
Enumeration Date | 2022-06-07 |
Last Update Date | 2025-05-07 |