NPI | 1407821077 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036126173) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 42286) |
Enumeration Date | 2006-02-17 |
Last Update Date | 2010-09-27 |