NPI | 1851699425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX E1341) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR C4288) |
Enumeration Date | 2011-03-07 |
Last Update Date | 2011-07-01 |