NPI | 1114086451 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 35632) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 57187) |
207R00000X Internal Medicine (Licence: HI 14859) | |
Enumeration Date | 2006-12-06 |
Last Update Date | 2008-07-30 |