NPI | 1740818350 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A23241) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A23241) |
Enumeration Date | 2020-03-30 |
Last Update Date | 2024-11-01 |