| NPI | 1841223658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 22418) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A73975) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2014-02-13 |