NPI | 1467498683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 30881) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 30881) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2018-01-23 |