NPI | 1932129095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 056135206) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 011873) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2012-08-15 |