NPI | 1619048204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 11050) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 00013753) |
Enumeration Date | 2006-11-13 |
Last Update Date | 2010-11-15 |