| NPI | 1437478385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301096113) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096113) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2019-04-17 |