| NPI | 1164544979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 43747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A97672) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-01-19 |