| NPI | 1922246529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD H0073714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA OP60386206) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2024-01-02 |