| NPI | 1144288317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR R4444) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR R-4444) |
| 208000000X Pediatrics (Licence: AR R-4444) | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2017-04-10 |