| NPI | 1598926248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 48428) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 48428) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2018-06-28 |