| NPI | 1639254436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: WA MD00017040) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00017040) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2013-12-03 |