NPI | 1588050678 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A13992) |
Additional Taxonomies | 282N00000X General Acute Care Hospital |
Enumeration Date | 2015-04-15 |
Last Update Date | 2019-05-21 |