| NPI | 1447348388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 02904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 02904) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2021-05-13 |