NPI | 1972918738 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 84985-20) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105183) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2025-01-22 |