| NPI | 1033158597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 21800) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NC 21800) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2023-03-07 |