| NPI | 1922014174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 78550) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G78550) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-07-13 |