| NPI | 1033305537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0037730)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0037730)  | 
| 208U00000X Clinical Pharmacology (Licence: MD D0037730)  | |
| Enumeration Date | 2007-09-18 | 
| Last Update Date | 2007-09-18 |