NPI | 1649333790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 136902) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 136902) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2007-07-08 |