NPI | 1669473559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX Q3519) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 055049) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2015-04-09 |