| NPI | 1114257771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 20A11091) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A11091) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2019-09-18 |