| NPI | 1043668577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD61076133) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD61076133) | |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2022-03-10 |