| NPI | 1407804503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-3188) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: AR E-3188) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2021-06-24 |