NPI | 1407839939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 156656) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 156656) |
Enumeration Date | 2005-11-29 |
Last Update Date | 2020-11-11 |