NPI | 1215998901 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: AZ 23040) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 23040) |
Enumeration Date | 2006-03-31 |
Last Update Date | 2013-06-06 |