| NPI | 1003443151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A186039) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL2967) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2024-05-08 |