NPI | 1003896895 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KS 04-33478) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO R9699) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2009-06-16 |