| NPI | 1558848143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AK 180637) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AK 180637) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2024-03-05 |