| NPI | 1538500186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 58215) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A138048) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2021-12-03 |