| NPI | 1871170811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A192916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GU MTL-2025-027) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2026-01-18 |