NPI | 1003924101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L3285) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 222240) |
207R00000X Internal Medicine (Licence: LA 15025R) | |
Enumeration Date | 2006-08-28 |
Last Update Date | 2011-08-10 |