| NPI | 1265412746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 00035350) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G66897) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-05-16 |