NPI | 1952507170 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01074832A) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D15904) |
207R00000X Internal Medicine (Licence: TX H3129) | |
207R00000X Internal Medicine (Licence: IL 036-059866) | |
Enumeration Date | 2007-06-25 |
Last Update Date | 2018-03-17 |