| NPI | 1538249495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9672) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 2049642) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2018-07-11 |