NPI | 1346240504 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0074218) |
Additional Taxonomies | 174400000X Specialist (Licence: FL 510444005) |
Enumeration Date | 2005-07-28 |
Last Update Date | 2013-12-05 |