NPI | 1235418385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL L5968R) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL L5968R) |
Enumeration Date | 2011-08-08 |
Last Update Date | 2024-06-10 |