| NPI | 1700045150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A99960) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A99960) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2021-12-08 |