| NPI | 1679812838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A144485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 144485) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2020-08-21 |