| NPI | 1427637123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61568300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD221513) |
| 207R00000X Internal Medicine (Licence: CA A196506) | |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2024-08-20 |