NPI | 1477566040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A64986) |
Additional Taxonomies | 174400000X Specialist (Licence: CA A64986) |
Enumeration Date | 2006-08-14 |
Last Update Date | 2013-01-28 |