| NPI | 1063427482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60064812) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD26104) |
| 207R00000X Internal Medicine (Licence: WA MD60064812) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-03-16 |