| NPI | 1437424595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA ML60286870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60491658) |
| 207R00000X Internal Medicine (Licence: AK MEDR8548) | |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2015-06-15 |