NPI | 1174615157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01028799) |
Additional Taxonomies | 208D00000X General Practice (Licence: IN 01028799A) |
Enumeration Date | 2006-09-28 |
Last Update Date | 2011-09-05 |