| NPI | 1821067836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 11142) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A101641) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2021-12-14 |