| NPI | 1427476100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2019009766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-00418) |
| 208000000X Pediatrics (Licence: MO 2019009766) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2021-02-12 |