NPI | 1932381126 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A39133) |
Additional Taxonomies | 208D00000X General Practice (Licence: CA a 39133) |
207Q00000X Family Medicine (Licence: CA A39133) | |
Enumeration Date | 2007-11-29 |
Last Update Date | 2011-04-05 |