| NPI | 1073538062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA md00037799) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD00037799) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2021-09-09 |