NPI | 1285683490 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 35067) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 35067) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2008-04-09 |