| NPI | 1700032497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A109924) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC 146762) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2016-03-24 |