NPI | 1902835317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C147049) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301087338) |
Enumeration Date | 2006-06-30 |
Last Update Date | 2017-05-12 |