| NPI | 1982851143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C192634) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD154091) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2024-05-01 |