| NPI | 1003903493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD70050842) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD70050842) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2025-12-17 |