NPI | 1720225816 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX N5288) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 001806) |
Enumeration Date | 2009-01-12 |
Last Update Date | 2014-08-15 |