NPI | 1386865780 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 41075) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 41075) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2011-05-12 |