| NPI | 1194773259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: CA G32447) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC19232) |
| 207R00000X Internal Medicine (Licence: CA G 032447) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2026-02-11 |