| NPI | 1982960449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2081H0002X (Licence: CA A143854) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A143854) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2016-08-16 |