| NPI | 1912535626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61248596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61248596) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-04-03 |