NPI | 1962542142 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 23934) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N0610) |
Enumeration Date | 2007-02-07 |
Last Update Date | 2012-03-15 |