NPI | 1154591246 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 55212) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 55212) |
Enumeration Date | 2008-03-05 |
Last Update Date | 2017-03-31 |