| NPI | 1487033437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301504391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A162458) |
| 208000000X Pediatrics (Licence: CA A162458) | |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2025-02-21 |