NPI | 1124023510 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 33319) |
Additional Taxonomies | 208D00000X General Practice (Licence: NC 33319) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2009-11-16 |