| NPI | 1467714022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60488613) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60488613) |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2024-04-11 |