| NPI | 1750768784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME134412) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A153852) |
| 207R00000X Internal Medicine (Licence: FL TRN21207) | |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2021-12-04 |