NPI | 1598853574 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME88911) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 011896) |
Enumeration Date | 2006-10-11 |
Last Update Date | 2011-12-21 |