| NPI | 1518928886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA a77785) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A77785) |
| 208000000X Pediatrics (Licence: CA a77785) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2014-08-14 |