| NPI | 1447563622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV DO2501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A121960) |
| 207R00000X Internal Medicine (Licence: VA 0116029271) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2019-07-02 |