NPI | 1831485838 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC LL33918) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 53685) |
Enumeration Date | 2011-06-28 |
Last Update Date | 2016-01-28 |