| NPI | 1063840999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP60793795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL OS13995) |
| 207R00000X Internal Medicine (Licence: FL UO3638) | |
| 208M00000X Hospitalist (Licence: FL OS13995) | |
| Enumeration Date | 2013-11-01 |
| Last Update Date | 2022-07-21 |