| NPI | 1326291865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C177977) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2016-02139) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2022-05-06 |