NPI | 1073595682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA c55035) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 235605) |
207R00000X Internal Medicine (Licence: TN MD40703) | |
Enumeration Date | 2005-11-18 |
Last Update Date | 2019-03-11 |