| NPI | 1669427449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00042522) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-8894) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-07-06 |