| NPI | 1588620918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A9356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A9356) |
| 207R00000X Internal Medicine (Licence: NV DO 1375) | |
| 207Q00000X Family Medicine (Licence: NV DO 1375) | |
| 207R00000X Internal Medicine (Licence: NV 1375) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-08-02 |