| NPI | 1932326956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A117392) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 24070) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2021-12-17 |