| NPI | 1336155597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 48222) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A48222) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-09-21 |