| NPI | 1215369418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 54660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A133659) |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2021-11-12 |