NPI | 1891928263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107131) |
Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: CA 550000708) |
Enumeration Date | 2009-09-01 |
Last Update Date | 2012-08-23 |