NPI | 1417057316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 11054) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 134958) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2021-10-21 |