| NPI | 1952374795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 0000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A75543) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2023-03-07 |