| NPI | 1326084021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP60216477) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: WA OP60216477) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2016-11-25 |