NPI | 1629177068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042.0013293) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD041176E) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2015-12-29 |