| NPI | 1932128873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CO DR.0048248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-112286) |
| 208000000X Pediatrics (Licence: IL 036-112286) | |
| 207R00000X Internal Medicine (Licence: CO DR.0048248) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-01-19 |