| NPI | 1841448859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245818) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A112779) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2021-11-29 |