| NPI | 1467771444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 274216) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD166742) |
| 207R00000X Internal Medicine (Licence: CO DR.0054091) | |
| 207R00000X Internal Medicine (Licence: WA MD 60446029) | |
| 207R00000X Internal Medicine (Licence: AK 8649) | |
| Enumeration Date | 2010-05-31 |
| Last Update Date | 2015-05-20 |