| NPI | 1366495616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2002014803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A78393) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2014-02-27 |