| NPI | 1447589478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 15217) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G43266) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2009-12-22 |