| NPI | 1114180916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A109581) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 14678) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2020-02-03 |