| NPI | 1750471231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR N-8139) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR N8139) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2008-02-08 |