NPI | 1730281361 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301066756) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301066756) |
Enumeration Date | 2006-09-03 |
Last Update Date | 2024-03-22 |