| NPI | 1770733859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60178773) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60178773) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2021-11-19 |