NPI | 1962039149 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301511082) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 12439701-1205) |
Enumeration Date | 2020-03-26 |
Last Update Date | 2024-07-08 |