NPI | 1932669330 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C2-0024133) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN DO0000004725) |
207R00000X Internal Medicine (Licence: TX T4142) | |
Enumeration Date | 2019-03-21 |
Last Update Date | 2022-09-16 |