NPI | 1639143688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 107306) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 3575) |
Enumeration Date | 2006-02-15 |
Last Update Date | 2014-01-07 |