| NPI | 1831319383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M6221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A111086) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-04-29 |