| NPI | 1922004019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine (Licence: PA MD017873E) |
| Additional Taxonomies | 2080P0205X Pediatrics, Pediatric Endocrinology (Licence: PA MD017837E) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2015-10-30 |