NPI | 1588866651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 000050430) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: CO 000050430) | |
Enumeration Date | 2007-06-01 |
Last Update Date | 2013-06-28 |