| NPI | 1407888944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A10477) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 226739) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2018-01-02 |