NPI | 1104808088 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.24413) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.24413) |
Enumeration Date | 2005-11-16 |
Last Update Date | 2023-03-23 |