NPI | 1326153131 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD201921) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA MD201921) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2017-02-17 |