| NPI | 1477512887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0050812) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0050812) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2018-04-27 |