| NPI | 1407980410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: CA A91996) |
| Additional Taxonomies | 2086S0129X (Licence: TN 50884) |
| 207R00000X Internal Medicine (Licence: CA A91996) | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2023-10-09 |