NPI | 1033158084 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 22784) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD426638) |
Enumeration Date | 2006-06-05 |
Last Update Date | 2012-10-23 |