| NPI | 1407086853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A130827) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML60096107) |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2016-11-21 |