| NPI | 1346454220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A112183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301091390) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-12-20 |