| NPI | 1083692412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA 208180) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60162698) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2022-01-31 |