| NPI | 1801823893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G175810) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD022085E) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2022-05-06 |