| NPI | 1225145626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C55000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 3436) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2015-01-17 |