| NPI | 1083026025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 60739952) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0449621) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2024-08-05 |