NPI | 1730566191 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A161568) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A161568) |
Enumeration Date | 2015-05-05 |
Last Update Date | 2020-03-06 |