NPI | 1760460323 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 28735) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 28735) |
Enumeration Date | 2006-01-04 |
Last Update Date | 2013-08-30 |