NPI | 1699743021 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 22943) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 00022943) |
Enumeration Date | 2006-03-10 |
Last Update Date | 2015-09-01 |