NPI | 1609882059 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2005-00438) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2005-00438) |
Enumeration Date | 2006-07-31 |
Last Update Date | 2013-01-16 |