| NPI | 1447663695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 277029) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A141308) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2018-11-28 |