| NPI | 1316956337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C 55703) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-1200296) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2021-11-09 |