| NPI | 1720271109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 12801644-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60459131) |
| 207Q00000X Family Medicine (Licence: UT 12801644-1204) | |
| 208M00000X Hospitalist (Licence: WA OP60459131) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-10-10 |