NPI | 1376592956 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME82542) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: FL ME87304) |
208000000X Pediatrics (Licence: FL ME82542) | |
Enumeration Date | 2006-05-09 |
Last Update Date | 2012-11-15 |