| NPI | 1992810550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0036980) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD 046054) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-04-20 |