NPI | 1013913219 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200000289) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200000289) |
Enumeration Date | 2005-06-22 |
Last Update Date | 2021-05-20 |