| NPI | 1083704902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A27783) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A35435) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-02-18 |