| NPI | 1558980003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D96993) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A183947) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2023-11-17 |