| NPI | 1700945128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0026556) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0026556) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2010-10-28 |