| NPI | 1144231853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G9323) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G9323) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2010-08-26 |