| NPI | 1548416670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C181395) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60287265) |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: WA MD60287265) | |
| 207R00000X Internal Medicine (Licence: WA MD60287265) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD60287265) | |
| 208D00000X General Practice (Licence: ZZ n/a) | |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2022-11-10 |