| NPI | 1740382613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR DO126329) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP61270808) |
| 207RI0200X Internal Medicine, Infectious Disease (Licence: OR DO126329) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2024-05-14 |