NPI | 1265484836 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 57167) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 057167) |
Enumeration Date | 2006-05-16 |
Last Update Date | 2012-01-09 |