| NPI | 1437260270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301047498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60971350) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-01-24 |