NPI | 1407064009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301094058) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301094058) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2009-07-01 |