| NPI | 1881918811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD198795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A125252) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2020-09-09 |