| NPI | 1891781746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60137745) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A108417) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2026-02-03 |