NPI | 1629810502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.084342) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.084342) |
Enumeration Date | 2024-06-11 |
Last Update Date | 2024-06-11 |