| NPI | 1902945926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A107041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI MD-15396) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2017-01-19 |