| NPI | 1396988788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI 15349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A107138) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2022-02-11 |