| NPI | 1346354131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 3218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2007-0046) |
| 208000000X Pediatrics (Licence: NM MD2007-0046) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2007-07-08 |