| NPI | 1225473226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 266030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A169774) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2021-08-30 |