NPI | 1003967100 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 74076) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101052100) |
207R00000X Internal Medicine (Licence: DC 20129) | |
207R00000X Internal Medicine (Licence: TX M8022) | |
Enumeration Date | 2007-01-15 |
Last Update Date | 2014-02-11 |