NPI | 1689638561 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9719) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX F5869) |
Enumeration Date | 2006-04-17 |
Last Update Date | 2013-03-26 |