| NPI | 1760593057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60022445) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60022445) |
| 173000000X Legal Medicine (Licence: GA 057771) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-04-15 |