| NPI | 1497865216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 52064) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML20008565) |
| 207R00000X Internal Medicine (Licence: IL 036123842) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-11-24 |