| NPI | 1790727535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD00042518) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD00042518) |
| 207R00000X Internal Medicine (Licence: WA MD00042518) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-11-26 |