| NPI | 1205127172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0010457) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD042999) |
| 207R00000X Internal Medicine (Licence: DC MD042999) | |
| 207R00000X Internal Medicine (Licence: MD D0079030) | |
| 208000000X Pediatrics (Licence: DE C1-0010457) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2020-07-15 |