| NPI | 1598007940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2017-00575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 60361990) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-12-07 |