NPI | 1750302188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A055299) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A55299) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2019-12-30 |