| NPI | 1033142922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 25607) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AZ 25607) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-08-18 |