| NPI | 1497925143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD29379) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A98474) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2009-08-19 |