NPI | 1316926090 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS 007183 L) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 01022011818) |
Enumeration Date | 2006-01-11 |
Last Update Date | 2007-07-08 |