| NPI | 1437314614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60322641) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD60322641) |
| Enumeration Date | 2008-07-27 |
| Last Update Date | 2022-02-11 |