NPI | 1942290275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00020220) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 22349) |
207QA0401X Family Medicine, Addiction Medicine (Licence: WA MD00020220) | |
208M00000X Hospitalist (Licence: WA MD00020220) | |
Enumeration Date | 2005-10-27 |
Last Update Date | 2019-07-22 |