| NPI | 1962506204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CT 025902) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 025902) |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2008-10-24 |