| NPI | 1811166572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A95103) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A95103) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: CA A95103) | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2026-06-10 |