| NPI | 1073752283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX bp10029227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX bp10029227) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2011-08-04 |