NPI | 1336381607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A117637) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 14412) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2016-06-20 |