NPI | 1902052160 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD445909) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 134734) |
207R00000X Internal Medicine (Licence: DC MD037603) | |
Enumeration Date | 2008-08-07 |
Last Update Date | 2014-08-05 |