| NPI | 1265444723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00040497) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OR MD158168) |
| 207R00000X Internal Medicine (Licence: OR MD158168) | |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2017-12-04 |