NPI | 1417918814 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200100738) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 200100738) |
Enumeration Date | 2006-03-28 |
Last Update Date | 2012-07-19 |