NPI | 1962506238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9614) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036093708) |
Enumeration Date | 2006-09-08 |
Last Update Date | 2018-11-19 |