NPI | 1336150259 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 36333) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46560-20) |
207R00000X Internal Medicine (Licence: CO 27582) | |
Enumeration Date | 2006-08-10 |
Last Update Date | 2011-03-08 |