| NPI | 1548672553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60785505) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA 60785505) |
| Enumeration Date | 2014-05-25 |
| Last Update Date | 2024-12-27 |