NPI | 1407830458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 2000237) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME60572) |
Enumeration Date | 2005-12-02 |
Last Update Date | 2007-07-08 |