NPI | 1992995997 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11360) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N6536) |
207R00000X Internal Medicine (Licence: MI 5101017225) | |
Enumeration Date | 2007-07-26 |
Last Update Date | 2012-07-02 |