NPI | 1467707034 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 1250) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A6294) |
207R00000X Internal Medicine (Licence: NJ 25MB04750200) | |
Enumeration Date | 2012-07-19 |
Last Update Date | 2012-07-20 |