NPI | 1750471546 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C133271) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 33822) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2015-05-18 |