| NPI | 1184124687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MD H0101709) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WA 7226621) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2024-10-24 |