NPI | 1760600605 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD431416) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD431416) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2008-12-17 |