| NPI | 1265600795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 20A10166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A10166) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2021-06-07 |