| NPI | 1235157868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 7451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G83146) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-12-01 |