NPI | 1093754921 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 52306) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 247441) |
Enumeration Date | 2006-06-06 |
Last Update Date | 2012-04-03 |