NPI | 1255772604 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301103085) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301103085) |
Enumeration Date | 2013-07-15 |
Last Update Date | 2023-02-22 |