| NPI | 1710203567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD 16331) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A118329) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2016-08-02 |