| NPI | 1598724437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SD 1432) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G87688) |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2019-11-06 |