NPI | 1265432793 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 6958) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M3534) |
Enumeration Date | 2005-07-27 |
Last Update Date | 2018-10-24 |