| NPI | 1912973546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00048179) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: WA MD00048179) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2018-03-12 |