| NPI | 1154399517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60196214) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME121235) |
| 208M00000X Hospitalist (Licence: WA MD60196214) | |
| 207Q00000X Family Medicine (Licence: OR MD27038) | |
| 207Q00000X Family Medicine (Licence: WI 48292) | |
| 208M00000X Hospitalist (Licence: OR MD27038) | |
| 208M00000X Hospitalist (Licence: WI 48292) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2025-06-05 |