| NPI | 1093701674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 10855) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G74858) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2023-03-07 |