NPI | 1083733273 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2008-00518) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35085805) |
208000000X Pediatrics (Licence: OH 35085805) | |
Enumeration Date | 2007-03-28 |
Last Update Date | 2023-04-17 |