| NPI | 1700140266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60813515) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IA 42230) |
| 207R00000X Internal Medicine (Licence: MI 4301100570) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2020-12-09 |