| NPI | 1932420320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 20A13845) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA oto13674) |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2016-02-24 |