| NPI | 1144531435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2014008976) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014008976) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2022-10-05 |