| NPI | 1336586775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 281181) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A133021) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2019-09-06 |