| NPI | 1427370618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A128745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 43028) |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2020-02-25 |