| NPI | 1528158698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD00028290) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00028290) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-09-26 |