| NPI | 1770090144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: VA 0101276052) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101276052) |
| 208000000X Pediatrics (Licence: VA 0101276052) | |
| Enumeration Date | 2018-01-06 |
| Last Update Date | 2024-06-28 |