| NPI | 1699091264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-8349) |
| Additional Taxonomies | 207RA0000X Internal Medicine Adolescent Medicine (Licence: AR E-8349) |
| 208000000X Pediatrics (Licence: AR E-8349) | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2024-06-13 |