| NPI | 1295902831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C177954) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C1777954) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2025-05-13 |