NPI | 1891018065 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 79623) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MA 79623) |
Enumeration Date | 2010-03-02 |
Last Update Date | 2014-07-18 |