| NPI | 1285969162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C162879) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 65981) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2024-04-12 |