NPI | 1871881466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 20140160) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA mt200577) |
Enumeration Date | 2011-07-16 |
Last Update Date | 2017-03-17 |