NPI | 1710118393 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 51353) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194224) |
Enumeration Date | 2009-07-30 |
Last Update Date | 2014-10-15 |