NPI | 1841678349 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX BP10052893) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX R5259) |
Enumeration Date | 2015-05-15 |
Last Update Date | 2018-07-11 |