| NPI | 1497933667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 48400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A125745) |
| 207R00000X Internal Medicine (Licence: AZ 42002) | |
| 207R00000X Internal Medicine (Licence: UT 6851493-1205) | |
| Enumeration Date | 2008-02-09 |
| Last Update Date | 2022-02-23 |