| NPI | 1336381607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A117637) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 14412) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2016-06-20 |