NPI | 1225356231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A127376) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A127376) |
Enumeration Date | 2010-05-14 |
Last Update Date | 2023-07-27 |