| NPI | 1841637576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 144256) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD61125444) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2024-01-24 |