NPI | 1962077263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101281246) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4351047534) |
Enumeration Date | 2021-05-20 |
Last Update Date | 2024-06-22 |