| NPI | 1841510385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A112199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 66766) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2023-02-24 |