NPI | 1164475158 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01021660) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01021660A) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2008-04-01 |