NPI | 1164758082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS11009) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO1852) |
Enumeration Date | 2009-10-28 |
Last Update Date | 2011-06-22 |