| NPI | 1083607295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 17998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00029384) |
| 207R00000X Internal Medicine (Licence: WA MD00029384) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2021-01-14 |