| NPI | 1073947818 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD61688963) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 50125) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2025-08-25 |