NPI | 1770608721 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0069537) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0069537) |
Enumeration Date | 2007-03-20 |
Last Update Date | 2013-04-22 |