NPI | 1760439095 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: KY 27947) |
Additional Taxonomies | 208000000X Pediatrics (Licence: KY 27947) |
Enumeration Date | 2006-05-30 |
Last Update Date | 2024-05-02 |