NPI | 1083776322 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A70884) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A70884) |
Enumeration Date | 2006-12-14 |
Last Update Date | 2024-09-12 |