| NPI | 1013114487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60266309) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR 100484) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NV 15408) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-03-01 |