| NPI | 1396833265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C42525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA DEABH2930128) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2010-06-30 |