NPI | 1063726792 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 47803) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R72059) |
Enumeration Date | 2010-08-05 |
Last Update Date | 2014-01-30 |