| NPI | 1275845570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A168081) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 57046) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2023-06-06 |