NPI | 1588781579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M8102) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT184861) |
Enumeration Date | 2007-03-23 |
Last Update Date | 2014-03-13 |