NPI | 1588644314 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 18639) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 22655) |
Enumeration Date | 2006-01-18 |
Last Update Date | 2012-05-11 |