NPI | 1861485179 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 15041) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MS 15041) |
Enumeration Date | 2005-08-23 |
Last Update Date | 2012-03-13 |