NPI | 1558103101 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4351053604) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4351053604) |
Enumeration Date | 2024-06-12 |
Last Update Date | 2024-06-12 |