NPI | 1205197464 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 28491) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6702) |
Enumeration Date | 2012-06-05 |
Last Update Date | 2018-07-03 |