NPI | 1962499897 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD09946) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA MD81257) |
Enumeration Date | 2005-10-05 |
Last Update Date | 2007-07-09 |