NPI | 1912483306 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D91041) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071703) |
Enumeration Date | 2018-07-18 |
Last Update Date | 2021-08-25 |