| NPI | 1679862023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-7184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A115997) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2019-04-17 |