| NPI | 1336241033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 013520) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: CT 013520) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2023-03-07 |