| NPI | 1841500683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 10130) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A113716) |
| 207R00000X Internal Medicine (Licence: HI 17017) | |
| 208000000X Pediatrics (Licence: CA A113716) | |
| 208000000X Pediatrics (Licence: HI 17017) | |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2019-07-24 |