| NPI | 1114114014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD00048902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00048902) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2019-08-27 |