| NPI | 1528107562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60051097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 2006-0328) |
| 208M00000X Hospitalist (Licence: WA md60051097) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2018-02-13 |