| NPI | 1235438730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD201097) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60403044) |
| Enumeration Date | 2011-03-23 |
| Last Update Date | 2024-08-07 |