NPI | 1528418670 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301110368) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301110368) |
Enumeration Date | 2016-06-20 |
Last Update Date | 2021-02-19 |