NPI | 1609958651 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 44393) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 44393) |
Enumeration Date | 2006-10-19 |
Last Update Date | 2013-02-12 |