NPI | 1144243254 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G40516) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV NV9160) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2007-07-08 |