NPI | 1235199795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: LA 024980) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 024980) |
Enumeration Date | 2006-03-27 |
Last Update Date | 2016-02-29 |