| NPI | 1972594984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00036836) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD00036836) |
| 208M00000X Hospitalist (Licence: WA MD00036836) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2024-02-26 |