| NPI | 1033187679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00046696) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD021030E) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-02-29 |