| NPI | 1538246061 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD d42518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD d42518) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MD d42518) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-10-01 |