| NPI | 1437353034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A112991) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: TX BP1-0026595) |
| 208000000X Pediatrics (Licence: CA A112991) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2021-12-15 |