| NPI | 1144603044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60993448) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO4396) |
| 208M00000X Hospitalist (Licence: WA OP60993448) | |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2022-08-11 |