NPI | 1972606028 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 43071) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 36103342) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2017-02-27 |