NPI | 1245250661 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 213950) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 213950) |
Enumeration Date | 2006-07-20 |
Last Update Date | 2012-02-14 |