| NPI | 1326086950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD212706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00037365) |
| 207R00000X Internal Medicine (Licence: CO 47891) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2023-01-26 |