NPI | 1184606279 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 10328) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 172907-1205) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2011-10-03 |