NPI | 1588749600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A89181) |
Additional Taxonomies | 207RI0200X Internal Medicine Infectious Disease (Licence: CA A89181) |
208D00000X General Practice (Licence: CA A89181) | |
Enumeration Date | 2006-10-26 |
Last Update Date | 2018-04-11 |