| NPI | 1083780746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00047036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA GFE 64378) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2023-01-10 |