| NPI | 1629181433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR C6451) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: AR C6451) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2024-10-07 |