NPI | 1457342255 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101233641) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101233641) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2009-09-23 |