NPI | 1811027675 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX S8516) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME114981) |
207R00000X Internal Medicine (Licence: FL ME114981) | |
Enumeration Date | 2007-03-07 |
Last Update Date | 2023-07-07 |