| NPI | 1932541448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A134874) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 084319) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2020-06-08 |