| NPI | 1134411267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A129828) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 260877) |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2023-01-13 |