| NPI | 1659875136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61105776) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD61105776) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-02-08 |