NPI | 1053413203 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 024563) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 024563) |
Enumeration Date | 2006-09-01 |
Last Update Date | 2011-01-20 |