| NPI | 1205279700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DC MD045941) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D83317) |
| 208000000X Pediatrics (Licence: MD D83317) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2018-05-18 |