NPI | 1316926082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 02383) |
Additional Taxonomies | 2080S0010X Pediatrics, Sports Medicine (Licence: IA 02383) |
Enumeration Date | 2006-01-11 |
Last Update Date | 2012-05-16 |