NPI | 1548758139 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD476758) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD476758) |
Enumeration Date | 2018-04-29 |
Last Update Date | 2022-11-09 |