NPI | 1407140056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60384423) |
Additional Taxonomies | 208M00000X Hospitalist (Licence: WA OP60384423) |
Enumeration Date | 2011-05-31 |
Last Update Date | 2022-01-18 |