| NPI | 1477114791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A181525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA PTL6606) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2024-10-17 |