NPI | 1730293028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 4215) |
Additional Taxonomies | 174400000X Specialist (Licence: PR 4215) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2016-09-12 |