| NPI | 1699724948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2017-02449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G46764) |
| Enumeration Date | 2006-05-06 |
| Last Update Date | 2018-03-14 |