| NPI | 1487116950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 25938) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A181122) |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2025-07-17 |