| NPI | 1225340227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 155921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101253337) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2023-06-21 |