NPI | 1760578777 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: MA 50614) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 50614) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2012-04-30 |