NPI | 1982864559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A119775) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A119775) |
Enumeration Date | 2008-06-16 |
Last Update Date | 2021-11-29 |