| NPI | 1013449354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY MD.61075325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD.61075325) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-10-08 |