NPI | 1164450169 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 00025726) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL 00025726) |
Enumeration Date | 2006-06-29 |
Last Update Date | 2025-06-29 |