| NPI | 1750481651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA A62253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A62253) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-11-19 |