| NPI | 1033110911 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD00048304) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT 4881) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-12-03 |