| NPI | 1841616034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 14185) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H0088879) |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2021-08-27 |