| NPI | 1578686697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WA MD60006032) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60006032) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: WA MD60006032) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2024-01-04 |