| NPI | 1427412071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61047293) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: WA MD61047293) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2020-09-23 |