| NPI | 1982895819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60599738) |
| Additional Taxonomies | 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: WA MD60599738) |
| 207R00000X Internal Medicine (Licence: OR MD28373) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2019-01-21 |