| NPI | 1437564788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2020-03008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.064867) |
| 207R00000X Internal Medicine (Licence: WA MD6154596) | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-06-04 |