| NPI | 1437119591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A99461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 46482) |
| 208000000X Pediatrics (Licence: MN 46482) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2019-09-16 |