| NPI | 1952481913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2014018787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A89450) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-01-26 |