NPI | 1306801121 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD19400) |
Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: OR MD19400) |
Enumeration Date | 2006-04-18 |
Last Update Date | 2010-07-15 |