| NPI | 1841604550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: SC MD37050) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC MD37050) |
| 207RA0201X Internal Medicine, Allergy & Immunology (Licence: MO 2018010783) | |
| 208000000X Pediatrics (Licence: SC MD37050) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2022-09-15 |