| NPI | 1174716583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A128575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 42035) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2023-04-17 |