NPI | 1912929928 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M3622) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00014668) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2007-07-08 |