| NPI | 1356409726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA AO60056) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A060056) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2020-06-23 |