| NPI | 1952382798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 22120) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 22120) |
| 2083C0008X Preventive Medicine Clinical Informatics (Licence: OK 22120) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2015-12-09 |