| NPI | 1144398678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL MD.35198) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301076363) |
| 208000000X Pediatrics (Licence: MI 4301076363) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2022-08-30 |