NPI | 1003853268 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI MD09837) |
Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: RI RI9837) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2017-02-10 |