| NPI | 1568951614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD61098450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61098450) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2022-07-11 |