| NPI | 1376517268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD00042788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M9046) |
| 207R00000X Internal Medicine (Licence: SD 9106) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2017-09-29 |