| NPI | 1588694475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 53737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A81307) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-06-30 |