| NPI | 1053738104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60680940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA ML 60469873) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2018-07-09 |