| NPI | 1649443276 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D89748) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD00036207) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2023-01-26 |