| NPI | 1184698516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A-45727) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO CDRH.0059064) |
| 207R00000X Internal Medicine (Licence: AL MD13956) | |
| 207R00000X Internal Medicine (Licence: AR E-11971) | |
| 207R00000X Internal Medicine (Licence: WA MD60906292) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2025-09-24 |