| NPI | 1427266279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-119781) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-047489) |
| 208000000X Pediatrics (Licence: IL 125-047489) | |
| 208000000X Pediatrics (Licence: IL 036-119781) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-09-26 |