| NPI | 1598933012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60415441) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA OP60415441) |
| 207Q00000X Family Medicine (Licence: IN 02003432A) | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2025-11-03 |