| NPI | 1003878752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 113515) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35067778R) |
| 207R00000X Internal Medicine (Licence: CA C51583) | |
| 207Q00000X Family Medicine (Licence: NV 11315) | |
| 207R00000X Internal Medicine (Licence: WA MD60547149) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-08-11 |