NPI | 1568481547 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00034014) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 34014) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2020-10-23 |