| NPI | 1174713846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2013-02292) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60239393) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2025-02-13 |