NPI | 1215919261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM MD2015-0605) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200301178) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2015-09-17 |