| NPI | 1235592023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD216902) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A153152) |
| 207R00000X Internal Medicine (Licence: WA MD61473627) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-01-19 |