| NPI | 1841366853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD163118) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA 60136533) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2015-11-30 |