NPI | 1457305104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 23927) |
Additional Taxonomies | 208000000X Pediatrics (Licence: SC 23927) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2019-06-12 |