| NPI | 1750438099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 47534) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C141433) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2024-09-24 |