| NPI | 1033464243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 16895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A136725) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2018-10-19 |