NPI | 1881855039 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX P3462) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101251832) |
208000000X Pediatrics (Licence: VA 0101251832) | |
Enumeration Date | 2008-06-20 |
Last Update Date | 2015-10-08 |