NPI | 1760443600 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301047298) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301047298) |
Enumeration Date | 2006-03-30 |
Last Update Date | 2021-03-04 |