| NPI | 1174064596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2019034401) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019034401) |
| 208000000X Pediatrics (Licence: MO 2019034401) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: MO 2019034401) | |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2024-04-25 |