NPI | 1588634760 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 19390) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46824) |
Enumeration Date | 2006-01-23 |
Last Update Date | 2013-06-06 |