| NPI | 1013003045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00046663) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OR MD12783) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2023-11-30 |