NPI | 1972595981 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD SD4230) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 4230) |
Enumeration Date | 2005-08-16 |
Last Update Date | 2012-04-18 |