NPI | 1144515321 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R8321) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME128639) |
Enumeration Date | 2011-06-15 |
Last Update Date | 2019-01-07 |