NPI | 1184042855 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2018011071) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY R3656) |
208000000X Pediatrics (Licence: MO 2018011071) | |
Enumeration Date | 2014-03-31 |
Last Update Date | 2024-09-03 |