| NPI | 1932467206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60642177) |
| Additional Taxonomies | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: WA MD60642177) |
| 208M00000X Hospitalist (Licence: WA MD60642177) | |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2024-05-15 |