NPI | 1427251677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 200650) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 200650) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2021-12-06 |