| NPI | 1255541371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60079338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60079338) |
| 208000000X Pediatrics (Licence: WA MD60079338) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2023-05-11 |