| NPI | 1942466859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A125242) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2009030096) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2023-05-16 |