| NPI | 1174608848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A51233) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-20773) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-04-03 |