| NPI | 1285681056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A45858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01063909A) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2019-10-08 |