NPI | 1770582603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 221540) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 221540) |
Enumeration Date | 2005-07-21 |
Last Update Date | 2024-07-11 |