| NPI | 1427206978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60270939) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 44155) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2021-04-29 |