| NPI | 1881751410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NM 2002 0248) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G073467) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2016-04-27 |