NPI | 1013020577 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC md32755) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD d0056687) |
207R00000X Internal Medicine (Licence: VA 0101239613) | |
Enumeration Date | 2006-08-17 |
Last Update Date | 2007-07-08 |