| NPI | 1598024382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202K00000X (Licence: CA A121021) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A121021) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-12-12 |