NPI | 1972564136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D19502) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D19502) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2007-11-21 |