| NPI | 1063489128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G53067) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD12985) |
| Enumeration Date | 2006-03-07 |
| Last Update Date | 2012-10-17 |