| NPI | 1487810321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 12770) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A97317) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2010-02-22 |