NPI | 1649497371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 5022) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NE 5022) |
Enumeration Date | 2007-04-20 |
Last Update Date | 2018-07-09 |