NPI | 1316248503 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P6221) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125057346) |
Enumeration Date | 2010-11-04 |
Last Update Date | 2020-10-09 |