NPI | 1851915557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 74299) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11780) |
Enumeration Date | 2020-05-29 |
Last Update Date | 2023-10-24 |