NPI | 1003174202 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036168804) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 036168804) |
Enumeration Date | 2012-04-25 |
Last Update Date | 2024-06-06 |