| NPI | 1780082263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OR MD204532) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD 60621796) |
| 207R00000X Internal Medicine (Licence: OR MD204532) | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2021-07-14 |