| NPI | 1043443716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60286403) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A102963) |
| Enumeration Date | 2009-08-28 |
| Last Update Date | 2013-04-24 |