NPI | 1922461359 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2020-02683) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2020-02683) |
Enumeration Date | 2016-04-02 |
Last Update Date | 2021-08-20 |