| NPI | 1669552485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A56066) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CA a056066) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2017-08-24 |