| NPI | 1851556286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 243061) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A113617) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2020-02-25 |