| NPI | 1700047180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11638) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 245774) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2018-07-26 |