| NPI | 1669933164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R79950) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A178673) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2024-10-25 |