| NPI | 1649238130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA a96949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 45913) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2021-11-29 |