| NPI | 1225472012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: ID M-13753) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60966900) |
| 207Q00000X Family Medicine (Licence: WA MD60966900) | |
| 207Q00000X Family Medicine (Licence: ID M-13753) | |
| 208M00000X Hospitalist (Licence: ID M-13753) | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2025-06-16 |