| NPI | 1821109364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD16630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A60240) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-04-19 |