NPI | 1942407226 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS10691) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-01564) |
Enumeration Date | 2007-06-29 |
Last Update Date | 2015-11-16 |