NPI | 1558393207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60320097) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD15257) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2013-04-25 |