| NPI | 1992969596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C128683) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 41934) |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2024-02-07 |