NPI | 1467614800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A99761) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A99761) |
208000000X Pediatrics (Licence: CA A99761) | |
Enumeration Date | 2008-06-26 |
Last Update Date | 2023-09-08 |