NPI | 1114081643 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-092049) |
Additional Taxonomies | 208D00000X General Practice (Licence: IL 036-092049) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2014-08-20 |