| NPI | 1821551151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD61264582) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD61264582) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-12-16 |