NPI | 1871114249 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: TX U5503) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U5503) |
Enumeration Date | 2020-04-27 |
Last Update Date | 2025-08-28 |