| NPI | 1528027471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G32972) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G032972) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2016-02-26 |