| NPI | 1316326507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61270783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61270783) |
| 207Q00000X Family Medicine (Licence: PA md462193) | |
| 207Q00000X Family Medicine (Licence: PA MT209093) | |
| 207R00000X Internal Medicine (Licence: WA MD61270783) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-10-27 |