| NPI | 1710009808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A60718) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A060718) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-10-14 |