| NPI | 1336274075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD18096) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA G59335) |
| 207R00000X Internal Medicine (Licence: HI MD13533) | |
| 207R00000X Internal Medicine (Licence: MI 4301065060) | |
| 207R00000X Internal Medicine (Licence: NV 7650) | |
| 207R00000X Internal Medicine (Licence: WA MD00030390) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |