NPI | 1104994631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301073836) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY 11106A) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2020-01-23 |