| NPI | 1396009973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60467030) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60467030) |
| 207Q00000X Family Medicine (Licence: WA ML60294892) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2021-06-03 |