NPI | 1811997927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 15764) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 72444) |
Enumeration Date | 2005-07-29 |
Last Update Date | 2012-12-03 |