| NPI | 1033171640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: HI MD-22848-0) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00042817) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-02-24 |