| NPI | 1033183371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MI 4301086395) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301086395) |
| 208000000X Pediatrics (Licence: MI 4301086395) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2012-09-11 |