NPI | 1386778033 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A780920) |
Additional Taxonomies | 174400000X Specialist (Licence: 00A780920) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2024-09-27 |