NPI | 1912985680 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 30615) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IA 30615) |
Enumeration Date | 2006-01-04 |
Last Update Date | 2012-05-16 |