| NPI | 1477751667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A116611) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A1166AA) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2023-02-24 |