| NPI | 1386978914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A13922) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS11762) |
| 207R00000X Internal Medicine (Licence: FL UO 2247) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2021-12-03 |