| NPI | 1609127950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA c178805) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 53277) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2023-11-10 |