NPI | 1316047400 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 33839) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 033839) |
208D00000X General Practice (Licence: GA 33839) | |
Enumeration Date | 2006-09-25 |
Last Update Date | 2020-07-31 |