NPI | 1164692570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C149817) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N5759) |
Enumeration Date | 2008-03-03 |
Last Update Date | 2019-09-20 |