| NPI | 1700924297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 9554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A67074) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-10-18 |