NPI | 1700223385 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 270913) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 270913) |
Enumeration Date | 2013-05-23 |
Last Update Date | 2025-10-07 |