| NPI | 1982717682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00044268) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A89152) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2022-02-04 |