NPI | 1245253012 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A34136) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A34136) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2011-09-12 |