| NPI | 1427144617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35-088895) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00040558) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-05-22 |