| NPI | 1588841399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD176847) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA a101190) |
| 207R00000X Internal Medicine (Licence: WA MD60640422) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2026-02-20 |