NPI | 1124061205 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 12,195) |
Additional Taxonomies | 174400000X Specialist (Licence: PR 12195) |
Enumeration Date | 2006-06-14 |
Last Update Date | 2017-03-02 |