NPI | 1952808446 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 65941) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 29594) |
Enumeration Date | 2018-04-10 |
Last Update Date | 2021-10-26 |