| NPI | 1144439266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60212399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60212399) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2025-05-20 |