| NPI | 1902906712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 28058) |
| Additional Taxonomies | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: SC 28058) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-10-20 |